Graph Analysis Tutoring Session

Editor’s Note: This article was originally published in 2013. The graphs shown are from an earlier version of AcuGraph; the current version is AcuGraph CS. The graph analysis techniques and clinical reasoning demonstrated here remain fully applicable.

Once you have used AcuGraph for a while, your graph analyzing skills become quite refined. Graphs begin to come alive and tell you a story of what is happening within your patient. Often, you begin to form a hypothesis before the patient even reveals their chief complaint.

Who wants to practice graph analysis?

I have two graph reports to share with you–from two different patients.

Patient #1:

Patient #2:

Tell me what you see when you analyze these two graphs.

• Are there similarities between the two graphs?
• Are there differences between them?
• What types of questions would you ask your patient if they presented with either of these graphs?
• What working diagnosis are you forming in your mind when you see these graphs?
• What common points would you use to treat both of these patients?
• What different points might you consider adding for Graph #1 or Graph #2 based on the differences between the graphs?
• Are there any emotional components you would want to ask your patient about?
• Are there any dietary factors you would want to ask your patient about?
• If you have a TCM background, what TCM diagnosis might you begin to hypothesize?

The Analysis

Take a moment to study the graphs above and consider the questions before reading on. When you’re ready, here’s a detailed analysis of both patients.

Patient #1

Patient #2:

You’ll notice that both of these graphs show an upper/lower body imbalance. Graph #1 has a larger concentration of energy in the upper body, and in graph #2 the energy is focused more in the lower body.

Questions

Even without the patient telling me their chief complaint–my mind immediately begins formulating questions.

Graph #1:

• Are you experiencing any neck and/or shoulder tension?
• How have your emotions been? Have you been suffering with anxiety?

Graph #2:

• Are you experiencing low back pain? Headaches–frontal, temporal, occipital, vertex?
• Are you having any bloating? How about swelling/edema in the lower body?
• Female: Tell me about your menstrual cycle? Do you experience PMS, cramping or clots? Are you having any problems with vaginal discharge?
• Male: Do you have an enlarged prostate?

Commonalities

Both patients have spleen deficiency. If energy isn’t flowing smoothly through the middle jiao, it would make sense that the Spleen cannot perform its job of transporting and transforming food into energy efficiently.

My immediate goal would be to treat the Dai Mai and the Spleen. Once these imbalances are resolved, I would expect the patient to present with a completely different diagnosis on the next visit.

Points that I would choose are as follows:

• Dai Mai: TE 5, GB 41
• Spleen: CV 12; SP 6, ST 36

Treatment Approaches

Extra points that I would consider using–beyond the points listed above might include the following.

Graph #1:

• CV 17
• HT 7
• Neck and/or shoulder treatment

Graph #2:

• LR 6: This is the Xi Cleft for the channel. I have found that creating swift movement up the Liver channel helps energy disperse from the lower body up.
• Back shu treatment: This will affect all the channels that are out of balance and create nice movement in the bladder channel in general.

TCM

Can you begin to formulate any TCM patterns by looking at the graph? Of course you’ll need to use additional diagnostic skills beyond AcuGraph to come up with a full TCM pattern diagnosis, but do you get any clues of what you might find just by looking at the graph. Here are a few thoughts that come to my mind:

Graph #1:

• Heart Fire
• Spleen Qi Deficiency
• Fire not promoting Earth

Graph #2:

• Liver Yang Rising
• Stomach Fire
• Spleen Qi Deficiency
• Liver overacting on Earth

Chief Complaint

I didn’t tell you these patients’ chief complaints before we began picking the graph apart for a couple of reasons. First, I wanted you to realize that, with a little practice, you can gain a lot of information simply by analyzing the graph. Second, often I graph the patient before I ask the chief complaint, just so that I can “guess” what is going on in their body based on my graph findings.

Patient #1: This patient had just lost her mother to cancer. Obviously, she was going through a lot of emotional turmoil. Her body was experiencing the residuals of emotional trauma. Her heart channel was full–emotionally and energetically.

Patient #2: Her chief complaint was bilateral low back pain. She also has chronic digestion problems, including a lot of gas and bloating. Her diet is poor, and she drinks of a lot of ICE water and diet soda.

We hope you enjoyed this graph analysis exercise. The key takeaway: with practice, you can gain tremendous clinical insight simply by analyzing the graph — often before the patient reveals their chief complaint.

Kimberly Thompson, L.Ac.
Acupuncture Research Analyst

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